Individual Cub Scout Record Form
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1
2INDIVIDUAL CUB SCOUT RECORD
Cub Scout Den _____________________
Webelos Den _____________________
Pack No.___________
PERSONAL DATA
MEMBERSHIP
Name _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Former Tiger Cub (yes or no) ___________________________
Address _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Number of years in another pack ________________________
Date
City, State, Zip ____________________________________________________
Joined this pack ______________________________________
Home phone ______________________________________________________
Will complete grade 3 or become 10 ______________________
Date of birth ______________________________________________________
To Webelos den ______________________________________
Religious organization ____________________________________________
To another pack ______________________________________
School ______________________________________________________
Dropped from pack ___________________________________
Tenure when separated:
Parent’s or guardian’s name ______________________________________
Less than 1 year
1 to 2 years
2 to 3 years
Business address ________________________________________________
SERVICE AWARDS
City, State, Zip ____________________________________________________
1-Year
2-Year
3-Year
4-Year
Business phone __________________________________________________
Service stars
Occupation _________________________________________
Perfect attendance
ATTENDANCE AND DUES
D = Present at den meeting
S = Present at special pack activity
Write in year and month
P = Present at pack meeting
50, 75 = Amount paid on date shown (dues)
F = Family represented
= Dues paid ahead or back
YEAR
YEAR
YEAR
YEAR
ATTENDANCE
ATTENDANCE
ATTENDANCE
ATTENDANCE
DATE
DATE
DATE
DATE
DATE
DATE
DATE
DATE
DATE
DATE
DATE
DATE
DATE
DATE
DATE
DATE
DATE
DATE
DATE
DATE
DATE
DATE
DATE
DATE
DATE
DATE
DATE
DATE
DATE
DATE
DATE
DATE
DATE
DATE
DATE
DATE
DATE
DATE
DATE
DATE
DATE
DATE
DATE
DATE
DATE
DATE
DATE
DATE
BUDGET: The dues collected should cover the following items in the pack budget: registration, Boys’ Life,
accident insurance, reserve fund, program materials, activities.
ResouRces, FoRms, and applications
34-29
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